Key result
A survey of 306 physicians showed that only 6.7% had access to a multidisciplinary team for AF-CKD management and 44.7% routinely screened CKD patients for AF, highlighting inter-specialty gaps.
Why the study?
To gain insight into the management of AF in patients with CKD and adherence to current European Society of Cardiology AF Guidelines in contemporary clinical practice.
Cross-Sectional (n=306)
Yes
This survey highlights significant heterogeneity and knowledge gaps between cardiologists and nephrologists in managing AF in patients with CKD, emphasizing the need for multidisciplinary care.
The European Heart Rhythm Association (EHRA) and European Renal Association/European Dialysis and Transplantation Association (ERA/EDTA) jointly conducted a physician-based survey to gain insight into the management of atrial fibrillation (AF) in patients with chronic kidney disease (CKD) and adherence to current European Society of Cardiology AF Guidelines in contemporary clinical practice. Physician-based survey conducted during an 8-week period using an internet-based questionnaire sent to all EHRA and ERA/EDTA members, with voluntary and anonymous responses. Among 306 physicians (160 EHRA and 146 ERA/EDTA members; 56 countries), a multidisciplinary team for management of AF-CKD patients was available to only 20/300 respondents (6.7%) and 132/295 (44.7%) routinely screened CKD patients for AF. Oral anticoagulation (OAC) use was based on individual stroke risk in mild/moderate CKD but on shared decision-making in advanced CKD. The CHA2DS2-VASc score-based decisions were more common among cardiologists, with substantial intra- and inter-specialty heterogeneity in the use and dosing of specific OAC drugs across CKD stages, heterogeneous strategies for OAC monitoring (especially among nephrologists) and a modest impact of CKD on rate and rhythm control treatment decisions. The HAS-BLED score was generally not a determinant of OAC prescribing. Our survey provided important insights into contemporary management of AF patients with CKD in clinical practice, revealing certain differences between nephrologists and cardiologists and highlighting shared and specific knowledge gaps and unmet needs. These findings emphasize the need for streamlining the care for AF patients across different specialties and may inform development of tailored education interventions.
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Potpara et al. (2019) conducted a cross-sectional in Atrial fibrillation in chronic kidney disease (n=306). Physician specialty (Cardiology vs Nephrology) was evaluated on Survey responses regarding management of AF in CKD patients. A survey of 306 physicians showed that only 6.7% had access to a multidisciplinary team for AF-CKD management and 44.7% routinely screened CKD patients for AF, highlighting inter-specialty gaps.
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